REPORT
/ INTERNATIONAL NEWS

Medical waste: What cures you may end up killing you

The management of healthcare waste
requires increased attention and diligence to avoid the substantial disease
burden associated with poor practice, including exposure to infectious agents
and toxic substances, said experts at a seminar here at the University of
Health Sciences (UHS) on Monday.

The experts said that the unsafe
disposal of healthcare waste, such as contaminated syringes and needles, posed
a serious public health risk. “Contaminated needles and syringes represent a
particular threat as the failure to dispose of them safely may lead to
dangerous recycling and repackaging which may lead to unsafe reuse,” one speaker said.

The seminar on ‘Strategic analysis and
provision of new guidelines for the safe disposal of healthcare waste
management’ was organised by the UHS Immunology Department in collaboration
with the Environmental Health Protection Unit (EHPU), National Institute of
Health, Islamabad.

Dr Jamal Nasir, the focal person for
the EHPU, said staff, patients, and communities near hospitals were the most at
risk from faulty healthcare facility operations. “These are mostly caused by
not following infection control protocols, not using proper personal protective
equipment, and not employing proper procedures for waste collection,
transportation, storage and final disposal,” he said.

Proper management of
healthcare waste and effective implementation of the Hospital Waste Management
Rules of 2005 could minimise the risks both within and outside healthcare
facilities.

Dr Nasir said that safety
hazards in healthcare facilities were generally associated with handling of
sharps (needles, cutters), gases, autoclaves, and other equipment. Open burning
of hospital waste also posed safety risks for the staff carrying out this
activity. These hazards included risk of cuts, pricks, gas poisoning, burning,
and other bodily injuries.

“Strictly following
standard operating procedures and protocols to handle sharps and proper use of
equipment, particularly prick-proof gloves and masks, is of foremost
importance,” he added.

Dr Ibrahim Mughal,
technical officer at the EHPU, said that hospital waste management was
deficient in many ways. There were no records and no one could be held
responsible for the prevailing mismanagement. Waste materials were collected by
sweepers who had no equipment or training to handle it properly.

The participants were
told that the Hospital Waste Management Rules 2005 had been notified but were
still be implemented in 70-80 per cent of hospitals through the formation of
advisory committees and hospital waste management teams.

Hassan Nasir, manager of
the waste management department at Shalamar Hospital Lahore, said that an
estimated 80,000 tonnes of hospital waste was produced every month in the
Punjab.

“Out of this, only 15 to
20 per cent of hospital waste is infectious in nature, but it is mixed with
solid waste and thus contaminates the entire lot,” he said.

Around 2kg of waste per
bed per day is produced out of which 0.1-0.5 per cent could be categorised as a
health risk, Nasir added.

The incidence of
hepatitis B and C has increased in the country, with the average prevalence of
Hepatitis B ranging between 3 and 4 per cent (around 6 million people) and
Hepatitis C at around 5 percent (7.5 million), he said.

Azmat Naz, deputy
director of the Environment Protection Agency, said that the first priority was
to segregate wastes, preferably at the point of generation, into reusable and
non-reusable, hazardous and non-hazardous components.

Other important steps
were the institution of a sharps management system, waste reduction, avoidance
of hazardous substances, ensuring worker safety, providing secure methods of
waste collection and transportation, and installing safe treatment and disposal
mechanisms, she added.

UHS Immunology Department
head Dr Nadeem Afzal and Prof Tahir Naeem from the microbiology department of
Shalamar Hospital also spoke at the seminar.